The effect of a one-stage full-mouth disinfection on different intra-oral niches. Clinical and microbiological observations.
A treatment for periodontal infections often consists of consecutive rootplanings (per quadrant, at a 1- to 2-week interval), without a proper disinfection of the remaining intra-oral niches (untreated pockets, tongue, saliva, mucosa and tonsils). Such an approach, could theoretically lead to a reinfection of previously-treated pockets. The present study aims to examine the effect of a full-mouth disinfection on the microbiota in the above-mentioned niches. Moreover, the clinical benefit of such an approach was investigated. 16 patients with severe periodontitis were randomly allocated to a test and a control group. The patients from the control group were scaled and rootplaned, per quadrant, at 2-week intervals and obtained oral hygiene instructions. The patients from the test group received a full-mouth disinfection consisting of: scaling and rootplaning of all pockets in 2 visits within 24 h, in combination with tongue brushing with 1% chlorhexidine gel for 1 min, mouth rinsing with a 0.2% chlorhexidine solution for 2 min and subgingival irrigation of all pockets (3x in 10 min) with 1% chlorhexidine gel. Besides oral hygiene, the test group rinsed 2x daily with 0.2% chlorhexidine and sprayed the tonsils with a 0.2% chlorhexidine for 2 months. Plaque samples (pockets, tongue, mucosa and saliva) were taken at baseline and after 2 and 4 months, and changes in probing depth, attachment level and bleeding on probing were reported. The full-mouth disinfection resulted in a statistically significant additional reduction/elimination of periodontopathogens, especially in the subgingival pockets, but also in the other niches. These microbiological improvements were reflected in a statistically-significant higher probing depth reduction and attachment gain in the test patients. These findings suggest that a disinfection of all intra-oral niches within a short time span leads to significant clinical and microbiological improvements for up to 4 months.
Bollen
C M
CM
Department of Periodontology, Research Group for Microbial Adhesion, Catholic University of Leuven, Belgium.
Mongardini
C
C
Papaioannou
W
W
Van Steenberghe
D
D
Quirynen
M
M
D000328:Adult; D000336:Aerosols; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use*; D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000628:therapy; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D009061:Mouth Mucosa / Q000382:microbiology; D009910:Oral Hygiene; D014066:Palatine Tonsil / Q000382:microbiology; D010353:Patient Education as Topic; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010514:Periodontal Pocket / Q000188:drug therapy / Q000382:microbiology / Q000628:therapy; D010518:Periodontitis / Q000188:drug therapy / Q000382:microbiology* / Q000628:therapy; D012008:Recurrence; D016745:Root Planing; D012463:Saliva / Q000382:microbiology; D007507:Therapeutic Irrigation; D014059:Tongue / Q000382:microbiology; D014099:Toothbrushing
D000336:Aerosols; D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine